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Crisis nurse testifies veteran had 'anger issues' and outbursts that scared his daughter

The Desmond fatality inquiry has heard from three of the doctors who saw Afghanistan war veteran Lionel Desmond in the months before he killed his family and himself at their Nova Scotia home — but Tuesday it heard from another point of view: that of the nurses.

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Heather Wheaten felt the Afghanistan veteran with PTSD had no plans to harm himself or others

On Jan. 3, 2017, Lionel Desmond shot his daughter, mother, wife and then himself in a home in Upper Big Tracadie. A fatality inquiry is looking into the support services available to the Afghanistan war veteran. (Dave Irish/CBC)

The Desmond fatality inquiry has heard from three of the doctors who saw Afghanistan war veteran Lionel Desmond in the months before he killed his family and himself at their Nova Scotia home — but Tuesday it heard from another point of view: that of the nurses.

Crisis nurse Heather Wheaten told the inquiry that nurses will sometimes get a different view of a patient than physicians, because patients — especially former soldiers — see a doctor as an authority figure.

As Judge Warren Zimmer hopes to make recommendations to prevent further deaths, like those at the heart of this fatality inquiry, he's looking at whether there were gaps as someone moved from military care to the civilian health-care system.

Desmond, who suffered from post-traumatic stress disorder, spent more than two months without any therapy as he waited for Veterans Affairs to arrange for it near his home in Upper Big Tracadie, N.S., upon returning from an in-patient program in Montreal.

The "worsening of PTSD symptoms," according to Wheaten, pushed him and his wife, Shanna, to the emergency room at St. Martha's Regional Hospital in Antigonish, N.S., on Oct. 24, 2016, as a last resort to get therapy.

Wheaten spoke with them both, with Shanna — also a psychiatric nurse — appearing to manage and advocate for her husband's care, she said. Desmond himself seemed "downcast and unkempt" and spoke of having increasingly intense nightmares, night sweats, little appetite, anxiety and depression.

A collage of Lionel Desmond, his wife Shanna, his mother Brenda, his 10-year-old daughter, Aaliyah, and his military comrades. (CBC)

Domestic violence

The inquiry has also been asked to probe whether the civilian clinicians who saw Desmond were trained to recognize the symptoms of post-traumatic stress disorder and domestic violence.

Both intersect in this case.

The inquiry heard last week about Desmond's one-night stay in hospital two months later. He was released on Jan. 2, 2017, the day before he killed his wife, his 10-year-old daughter, Aaliyah, and his mother, Brenda, at thee home where he'd been living before his wife asked him to leave on New Year's Eve.

When Wheaten saw him roughly two months before that, she helped the couple make a plan to deal with Desmond's "anger issues."

Dr. Faisal Rahman testified earlier that he didn't believe Desmond a risk to himself or others. (Laura Fraser/CBC)

"I remember [Shanna] talking about how there was an incident where [her husband] had banged his hand … on a table and Aaliyah was in the room," she testified.

"I remember that [Shanna] said that 'I took [my daughter] aside and I explained to her that Daddy wasn't mad at her, that he was just feeling frustrated and angry and it didn't have anything to do with her.'"

Wheaten testified that she told the couple this kind of behaviour "wasn't healthy" and said she asked Shanna if she had support nearby. Desmond said that if he felt his "frustration building," he would go outside and work on a project to cool down.

Hospital visits

Desmond would show up at the emergency room at St. Martha's hospital two other times. In one case, on Dec. 1, 2016, he left after several hours without being seen.

On Jan. 1, 2017, he spent the night there. He'd shown up in crisis after his wife had asked him to leave the night before following another instance of Desmond yelling for hours and smashing furniture

Although he was kept overnight, the psychiatrist who released Desmond told the inquiry there were no signs he would harm himself or anyone else.

But evidence already presented suggests the nurses may have seen a different version of Desmond that night, one who slept poorly and was restless. They wrote about that in his chart, the inquiry has heard, but Dr. Faisal Rahman — the psychiatrist who saw him — didn't read it again before releasing Desmond.